Complete this form if you have been approved for a Leave of Absence and would like to maintain your UHIP coverage. Please note: To be eligible, you must have receive approval for the Leave of Absence at least one month prior to its start date, unless the leave is due to accident or illness. UHIP coverage for Leave of Absence is available for a maximum of one term over a 12-month period in an academic year. In cases of medical leave, coverage may be extended to a second term, but not beyond that. The UHIP fee is $66/month for each member (and each dependent, if applicable). In some cases, students may have already paid the annual premium and will require reimbursement for the unused months of coverage. This will be assessed upon review of your application. If you have any questions, please contact the UHIP team at uhip@ontariotechu.ca.
Undergraduate: Bachelor's, Undergraduate Diplomas, Professional Programs. Graduate: Master's, Doctorate, Graduate Diplomas.
Submissions not meeting the eligibility criteria will be denied.